Neuromyelitis Optica Spectrum Disorder in a sample of children: Experience of Children Welfare Teaching Hospital, Baghdad

Background: Neuromyelitis optica spectrum disorder is a rare autoimmune disease with a chronic inflammatory demyelinating characteristics that affects the central nervous system. No data is available about that disease in Iraq. Methods: A prospective / retrospective cross-sectional study has been carried out in the period from August 2019 to September 2020, in pediatric neurology ward in Children Welfare Teaching Hospital, Baghdad. The total of 13 patients were included in the current study. Results: Girls represent 61.5% (8), and the female: male ration was (1.6:1). The patients' ages ranged from 3 to 16 years (mean 9.3 ± 4.02 years). All patients younger than 6 years were AQP-ve, in contrast to 15.3% in those older than 6 year. Negative AQP patients equally distributed between males and females. While females predominated in those with AQP positive status (5,71.4%). Weakness of the limbs (7, 100% versus 6, 100%) and sphincteric disturbance (5, 71.4% versus 6, 100%) were the first two common clinical features in both AQP positive and AQP negative patients, respectively. The three most common brain sites insulted were deep white matter (10, 76.9%), periaqueductal area (5, 38.4%), and brainstem (4, 30.7%), showing no significant difference between AQP +ve and -ve patients. All patients showed long spinal lesions. Contrasted orbital MRI exhibited abnormal signals in 1/4 patients. Conclusion: There was a sharp rise in the frequency rate of neuromyelitis optica during 2019 and the demographic characteristics of the present cohort were comparative to that reported in the literature.
Keywords: Neuromyelitis optica spectrum disorder, children, Iraq